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  1. Medicines management, medication errors and adverse medication events in older people referred to a community nursing service: a retrospective observational study. | PSNet

    psnet.ahrq.gov/issue/medicines-management-medication-errors-and-adverse-medication-events-older-people-referred
    January 06, 2016 - Study Medicines management, medication errors and adverse medication events in older people referred to a community nursing service: a retrospective observational study. Citation Text: Elliott RA, Lee CY, Beanland C, et al. Medicines Management, Medication Errors and Adverse Medication E…

  2. Surgical patient safety officers in the United States: negotiating contradictions between compliance and workplace transformation. | PSNet

    psnet.ahrq.gov/issue/surgical-patient-safety-officers-united-states-negotiating-contradictions-between-compliance
    December 31, 2018 - Commentary Surgical patient safety officers in the United States: negotiating contradictions between compliance and workplace transformation. Citation Text: van de Ruit C, Bosk CL. Surgical patient safety officers in the United States: negotiating contradictions between compliance and wo…

  3. If only...: failed, missed and absent error recovery opportunities in medication errors. | PSNet

    psnet.ahrq.gov/issue/if-only-failed-missed-and-absent-error-recovery-opportunities-medication-errors
    July 15, 2009 - Study If only...: failed, missed and absent error recovery opportunities in medication errors. Citation Text: Habraken MMP, van der Schaaf TW. If only..: failed, missed and absent error recovery opportunities in medication errors. Qual Saf Health Care. 2010;19(1):37-41. doi:10.1136/qsh…

  4. Preventing medication errors in community pharmacy: frequency and seriousness of medication errors. | PSNet

    psnet.ahrq.gov/issue/preventing-medication-errors-community-pharmacy-frequency-and-seriousness-medication-errors
    June 14, 2011 - Study Preventing medication errors in community pharmacy: frequency and seriousness of medication errors. Citation Text: Knudsen P, Herborg H, Mortensen AR, et al. Preventing medication errors in community pharmacy: frequency and seriousness of medication errors. Qual Saf Health Care. …

  5. Letter to Health Care Providers: Safe Use of Surgical Staplers and Staples. | PSNet

    psnet.ahrq.gov/issue/letter-health-care-providers-safe-use-surgical-staplers-and-staples
    October 20, 2021 - Press Release/Announcement Letter to Health Care Providers: Safe Use of Surgical Staplers and Staples. Citation Text: Letter to Health Care Providers: Safe Use of Surgical Staplers and Staples. US Food and Drug Administration. October 7, 2021. Copy Citation Save S…

  6. Missed lesions at abdominal oncologic CT: lessons learned from quality assurance. | PSNet

    psnet.ahrq.gov/issue/missed-lesions-abdominal-oncologic-ct-lessons-learned-quality-assurance
    April 21, 2011 - Study Missed lesions at abdominal oncologic CT: lessons learned from quality assurance. Citation Text: Siewert B, Sosna J, McNamara A, et al. Missed lesions at abdominal oncologic CT: lessons learned from quality assurance. Radiographics. 2008;28(3):623-38. doi:10.1148/rg.283075188. …

  7. The Institute of Medicine report on medical errors—could it do harm? | PSNet

    psnet.ahrq.gov/issue/institute-medicine-report-medical-errors-could-it-do-harm
    February 18, 2011 - Commentary Classic The Institute of Medicine report on medical errors—could it do harm? Citation Text: Brennan TA. The Institute of Medicine report on medical errors--could it do harm? N Engl J Med. 2002;342(15):1123-1125. doi:10.1056/nejm200004133421510. Co…

  8. Human factors systems approach to healthcare quality and patient safety. | PSNet

    psnet.ahrq.gov/issue/human-factors-systems-approach-healthcare-quality-and-patient-safety
    October 03, 2013 - Commentary Human factors systems approach to healthcare quality and patient safety. Citation Text: Carayon P, Wetterneck TB, Rivera-Rodriguez J, et al. Human factors systems approach to healthcare quality and patient safety. Appl Ergon. 2014;45(1):14-25. doi:10.1016/j.apergo.2013.04.02…

  9. Variation in the rates of adverse events between hospitals and hospital departments. | PSNet

    psnet.ahrq.gov/issue/variation-rates-adverse-events-between-hospitals-and-hospital-departments
    July 26, 2011 - Study Variation in the rates of adverse events between hospitals and hospital departments. Citation Text: Zegers M, de Bruijne M, Spreeuwenberg P, et al. Variation in the rates of adverse events between hospitals and hospital departments. Int J Qual Health Care. 2011;23(2):126-33. doi:10…

  10. Medication safety and the administration of intravenous vincristine: international survey of oncology pharmacists. | PSNet

    psnet.ahrq.gov/issue/medication-safety-and-administration-intravenous-vincristine-international-survey-oncology
    March 26, 2015 - Study Medication safety and the administration of intravenous vincristine: international survey of oncology pharmacists. Citation Text: Gilbar P, Chambers C, Larizza M. Medication safety and the administration of intravenous vincristine: international survey of oncology pharmacists. J On…

  11. Medical errors reported by French general practitioners in training: results of a survey and individual interviews. | PSNet

    psnet.ahrq.gov/issue/medical-errors-reported-french-general-practitioners-training-results-survey-and-individual
    March 10, 2011 - Study Medical errors reported by French general practitioners in training: results of a survey and individual interviews. Citation Text: Venus E, Galam E, Aubert J-P, et al. Medical errors reported by French general practitioners in training: results of a survey and individual intervie…

  12. Improving radiology report quality by rapidly notifying radiologist of report errors. | PSNet

    psnet.ahrq.gov/issue/improving-radiology-report-quality-rapidly-notifying-radiologist-report-errors
    May 29, 2019 - Study Improving radiology report quality by rapidly notifying radiologist of report errors. Citation Text: Minn MJ, Zandieh AR, Filice RW. Improving Radiology Report Quality by Rapidly Notifying Radiologist of Report Errors. J Digit Imaging. 2015;28(4):492-8. doi:10.1007/s10278-015-9781-…

  13. Peer support and second victim programs for anesthesia professionals involved in stressful or traumatic clinical events. | PSNet

    psnet.ahrq.gov/issue/peer-support-and-second-victim-programs-anesthesia-professionals-involved-stressful-or
    October 26, 2022 - Study Peer support and second victim programs for anesthesia professionals involved in stressful or traumatic clinical events. Citation Text: Finney RE, Jacob AK. Peer support and second victim programs for anesthesia professionals involved in stressful or traumatic clinical events. Adv …

  14. The impact of drug shortages on patients with cardiovascular disease: causes, consequences, and a call to action. | PSNet

    psnet.ahrq.gov/issue/impact-drug-shortages-patients-cardiovascular-disease-causes-consequences-and-call-action
    October 10, 2012 - Review The impact of drug shortages on patients with cardiovascular disease: causes, consequences, and a call to action. Citation Text: Reed BN, Fox ER, Konig M, et al. The impact of drug shortages on patients with cardiovascular disease: causes, consequences, and a call to action. Am He…

  15. IOM: shorten residents' work shifts to reduce fatigue, improve patient safety. | PSNet

    psnet.ahrq.gov/issue/iom-shorten-residents-work-shifts-reduce-fatigue-improve-patient-safety
    January 31, 2024 - Journal Article IOM: shorten residents' work shifts to reduce fatigue, improve patient safety. Citation Text: Kuehn BM. IOM: Shorten residents' work shifts to reduce fatigue, improve patient safety. JAMA. 2009;301(3):259-61. doi:10.1001/jama.2008.940. Copy Citation Format: …

  16. Educating for the 21st-century health care system: an interdependent framework of basic, clinical, and systems sciences. | PSNet

    psnet.ahrq.gov/issue/educating-21st-century-health-care-system-interdependent-framework-basic-clinical-and-systems
    August 28, 2024 - Commentary Educating for the 21st-century health care system: an interdependent framework of basic, clinical, and systems sciences. Citation Text: Gonzalo JD, Haidet P, Papp KK, et al. Educating for the 21st-Century Health Care System: An Interdependent Framework of Basic, Clinical, and …

  17. The role of error in organizing behaviour. | PSNet

    psnet.ahrq.gov/issue/role-error-organizing-behaviour
    April 21, 2011 - Study Classic The role of error in organizing behaviour. Citation Text: Rasmussen J. The role of error in organizing behaviour. Qual Saf Health Care. 2003;12(5):377-383. doi:10.1136/qhc.12.5.377. Copy Citation Format: DOI Google Scholar BibTeX End…

  18. Resident perceptions of the impact of work hour limitations. | PSNet

    psnet.ahrq.gov/issue/resident-perceptions-impact-work-hour-limitations
    August 04, 2021 - Study Resident perceptions of the impact of work hour limitations. Citation Text: Lin GA, Beck DC, Stewart AL, et al. Resident perceptions of the impact of work hour limitations. J Gen Intern Med. 2007;22(7):969-75. Copy Citation Format: Google Scholar PubMed BibTeX EndNo…

  19. Provider and pharmacist responses to warfarin drug–drug interaction alerts: a study of healthcare downstream of CPOE alerts. | PSNet

    psnet.ahrq.gov/issue/provider-and-pharmacist-responses-warfarin-drug-drug-interaction-alerts-study-healthcare
    July 29, 2020 - Study Provider and pharmacist responses to warfarin drug–drug interaction alerts: a study of healthcare downstream of CPOE alerts. Citation Text: Miller AM, Boro MS, Korman NE, et al. Provider and pharmacist responses to warfarin drug-drug interaction alerts: a study of healthcare downst…

  20. Understanding national coverage policies. Navigating the maze of HACs, serious reportable events, and wrong surgical sites. | PSNet

    psnet.ahrq.gov/issue/understanding-national-coverage-policies-navigating-maze-hacs-serious-reportable-events-and
    June 28, 2017 - Commentary Understanding national coverage policies. Navigating the maze of HACs, serious reportable events, and wrong surgical sites. Citation Text: Cook J, D'Amato C, Garrett G, et al. Understanding national coverage policies. Navigating the maze of HACs, serious reportable events, a…
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